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Leah Mcclimans [14]Leah M. McClimans [5]
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Leah McClimans
University of South Carolina
  1.  83
    A Theoretical Framework for Patient-Reported Outcome Measures.Leah McClimans - 2010 - Theoretical Medicine and Bioethics 31 (3):225-240.
    Patient-reported outcome measures (PROMs) are increasingly used to assess multiple facets of healthcare, including effectiveness, side effects of treatment, symptoms, health care needs, quality of care, and the evaluation of health care options. There are thousands of these measures and yet there is very little discussion of their theoretical underpinnings. In her 2008 Presidential address to the Society for Quality of Life Research (ISOQoL), Professor Donna Lamping challenged researchers to grapple with the theoretical issues that arise from these measures. In (...)
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  2.  12
    Moral Expertise in the Clinic: Lessons Learned From Medicine and Science.Leah McClimans & Anne Slowther - 2016 - Journal of Medicine and Philosophy 41 (4):401-415.
    Philosophers and others have questioned whether or not expertise in morality is possible. This debate is not only theoretical, but also affects the perceived legitimacy of clinical ethicists. One argument against moral expertise is that in a pluralistic society with competing moral theories no one can claim expertise regarding what another ought morally to do. There are simply too many reasonable moral values and intuitions that affect theory choice and its application; expertise is epistemically uniform. In this article, we discuss (...)
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  3.  4
    Clinical Outcome Measurement: Models, Theory, Psychometrics and Practice.Leah McClimans, John Browne & Stefan Cano - 2017 - Studies in History and Philosophy of Science Part A 65:67-73.
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  4.  19
    Health Policy, Patient‐Centred Care and Clinical Ethics.Leah M. McClimans, Michael Dunn & Anne‐Marie Slowther - 2011 - Journal of Evaluation in Clinical Practice 17 (5):913-919.
  5.  26
    Towards Self-Determination in Quality of Life Research: A Dialogic Approach.Leah McClimans - 2010 - Medicine, Health Care and Philosophy 13 (1):67-76.
    Health-related quality of life measures aim to assess patients’ subjective experience in order to gauge an increasingly wide variety of health care issues such as patient needs; satisfaction; side effects; quality of care; disease progression and cost effectiveness. Their popularity is undoubtedly due to a larger initiative to provide patient-centered care. The use of patient perspectives to guide health care improvements and spending is rooted in the idea that we must respect patients as self-determining agents. In this paper I look (...)
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  6.  43
    Quality of Life is a Process Not an Outcome.Leah McClimans & John P. Browne - 2012 - Theoretical Medicine and Bioethics 33 (4):279-292.
    Quality improvement mechanisms increasingly use outcome measures to evaluate health care providers. This move toward outcome measures is a radical departure from the traditional focus on process measures. More radical still is the proposal to shift from relatively simple and proximal measures of outcome, such as mortality, to complex outcomes, such as quality of life. While the practical, scientific, and ethical issues associated with the use of outcomes such as mortality and morbidity to compare health care providers have been well (...)
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  7.  31
    Can UK Clinical Ethics Committees Improve Quality of Care?Leah McClimans, Anne-Marie Slowther & Michael Parker - 2012 - HEC Forum 24 (2):139-147.
    Failings in patient care and quality in NHS Trusts have become a recurring theme over the past few years. In this paper, we examine the Care Quality Commission’s Guidance about Compliance: Essential Standards of Quality and Safety and ask how NHS Trusts might be better supported in fulfilling the regulations specified therein. We argue that clinical ethics committees (CECs) have a role to play in this regard. We make this argument by attending to the many ethical elements that are highlighted (...)
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  8.  17
    Interpretability, Validity, and the Minimum Important Difference.Leah McClimans - 2011 - Theoretical Medicine and Bioethics 32 (6):389-401.
    Patient-reported outcomes are increasingly used as dependent variables in studies regarding the effectiveness of clinical interventions. But patient-reported outcome measures (PROMs) do not provide intuitively meaningful data. For instance, it is not clear what a five point increase or decrease on a particular scale signifies. Establishing ‘interpretability’ involves making changes in outcomes meaningful. Attempts to interpret PROMs have led to the development of methods for identifying a minimum important difference (MID). In this paper, however, I draw on Charles Taylor’s distinction (...)
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  9.  3
    First Person Epidemiological Measures: Vehicles for Patient Centered Care.Leah M. McClimans - forthcoming - Synthese:1-17.
    Since the 1970’s epidemiological measures focusing on “health-related quality of life” or simply “quality of life” have figured increasingly as endpoints in clinical trials. Before the 1970’s these measures were known, generically, as performance measures or health status measures. Relabeled as “quality of life measures” they were first used in cancer trials. In the early 2000’s they were relabeled again as “patient-reported outcome measures” or PROMs, in their service to the FDA to support drug labeling claims. To the limited degree (...)
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  10.  29
    Choosing a Patient-Reported Outcome Measure.Leah M. McClimans & John Browne - 2011 - Theoretical Medicine and Bioethics 32 (1):47-60.
    There has been much philosophical interest regarding the ‘hierarchy of evidence’ used to determine which study designs are of most value for reporting on questions of effectiveness, prognosis, and so on. There has been much less philosophical interest in the choice of outcome measures with which the results of, say, an RCT or a cohort study are presented. In this paper, we examine the FDA’s recently published guidelines for assessing the psychometric adequacy of patient-reported outcome measures. We focus on their (...)
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  11.  34
    Elective Twin Reductions: Evidence and Ethics.Leah Mcclimans - 2010 - Bioethics 24 (6):295-303.
    Twelve years ago the British media got wind of a London gynecologist who performed an elective reduction on a twin pregnancy reducing it to a singleton. Perhaps not surprisingly, opinion on the moral status of twin reductions was divided. But in the last few years new evidence regarding the medical risks of twin pregnancies has emerged, suggesting that twin reductions are relevantly similar to the reductions performed on high-end multi-fetal pregnancies. This evidence has appeared to resolve the moral debate. In (...)
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  12. Undead Patriarchy and the Possibility of Love.Leah McClimans & J. Jeremy Wisnewski - 2009 - In Rebecca Housel & J. Jeremy Wisnewski (eds.), Twilight and Philosophy: Vampires, Vegetarians, and the Pursuit of Immortality. Wiley. pp. 163--75.
     
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  13.  24
    Place of Birth: Ethics and Evidence.Leah McClimans - 2017 - Topoi 36 (3):531-538.
    In the US and UK Births in obstetric units vastly outnumber births that take place outside of an obstetric unit. Still non-obstetric births are increasing in both countries. Is it professionally responsible to support a non-obstetric birth? It is morally responsible to choose to give birth at home? This debate has become heated with those on both sides finding empirical support for their positions. Indeed this moral debate is often carried out in terms of empirical evidence. While to some this (...)
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  14.  26
    The Art of Asking Questions.Leah M. McClimans - 2011 - International Journal of Philosophical Studies 19 (4):521 - 538.
    Abstract In this paper I discuss how we should distinguish legitimate from illegitimate questions. I will argue that we should not make such distinctions prior to asking our questions; that questioning is more of an art than a science and that this art is part of the art of conversation in general. Nonetheless, the desire to limit in advance the questions that we can legitimately ask is not infrequent. In the philosophy of science this ambition manifests in response to concerns (...)
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  15.  21
    Just Work, Russell Muirhead. Harvard University Press, 2004, 209 Pages. [REVIEW]Leah M. McClimans - 2006 - Economics and Philosophy 22 (3):455-460.
  16.  9
    Mary Briody Mahowald, Bioethics and Women, Across the Life Span.Leah McClimans - 2008 - Ethical Theory and Moral Practice 11 (2):229-230.
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  17. Elective Twin Reductions: Evidence and Ethics.Leah Mcclimans - 2010 - Bioethics 24 (6):295-303.
    ABSTRACTTwelve years ago the British media got wind of a London gynecologist who performed an elective reduction on a twin pregnancy reducing it to a singleton. Perhaps not surprisingly, opinion on the moral status of twin reductions was divided. But in the last few years new evidence regarding the medical risks of twin pregnancies has emerged, suggesting that twin reductions are relevantly similar to the reductions performed on high‐end multi‐fetal pregnancies. This evidence has appeared to resolve the moral debate.In this (...)
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  18. Measurement in Medicine: Philosophical Essays on Assessment and Evaluation.Leah McClimans (ed.) - 2017 - Rowman & Littlefield International.
    This volume introduces readers to the main philosophical issues of measurement in medicine, illustrating the connections between the natural and social sciences by integrating essays on causation, measuring instruments and issues of measurement and policy.
     
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  19. Review of Just Work. [REVIEW]Leah Mcclimans - 2006 - Economics and Philosophy 22 (3):455-460.